Biology homework help

Prospectus

Factors Associated with Maternal Mortality in Greater Accra Ghana 2016;

Case-Control Study

Prospectus: Factors associated with Maternal Mortality in greater Accra Ghana 2016;

Case-control Study

Problem Statement

Maternal death is defined as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes’’ (Menendez et al., 2008, p. 2). Though the causes and risk factors for maternal death are known and preventable, it is a major health problem concentrated in resource-poor regions of the world (Menendez et al., 2008) including Ghana. The reduction of maternal deaths is a key international development goal, therefore health policy and interventions targeted at significantly reducing it should be evidence-based (Khan et al., 2006).

Ghana documented a Maternal Mortality Ratio (MMR) of 350 per 100,000 live births for the year 2012 (Mahama, 2013), however some districts for example Osu Klottey sub metro of the Accra Metropolitan area in its report recorded 428 maternal deaths per 100,000 live births at the end of 2012. This is a 39 percent increment on the 309 per 100,000 live births recorded in 2011. According to Addo and Gudu (2017), the Accra Metropolitan Area, an urban and commercial metropolis in the Greater Accra region has seen collaborative implementation of health policies and programs geared towards reducing maternal mortality over the past three years. Urban populations are mostly assumed to have access to more quality health care systems than their rural counterparts (Addo & Gudu, 2017). However, urban health systems in many low income countries (LIC) and lower middle income countries (MIC) have weak to non-existent public health structures (Coast et al., 2012). They also lack uniform implementation strategies and inadequate infrastructure to improve population health (Coast et al., 2012). Even though Ghana in collaboration with its development partners has implemented interventions to reduce maternal mortality to achieve the United Nations’ Millenium Development Goal (MDG 5) targets, institutional maternal mortality was very high in Osu Klottey Sub Metro for 2016 with the majority (80%) of maternal deaths being among individuals who were antenatal clinic non attendants (Mahama, 2013). Studies have shown lack of access to obstetrics care due to the lack of health facilities, poor transportation system and greater distances between client home and health facilities (Kaye et al., 2003).

Although the causes of maternal deaths are well established, knowledge on effective management of conditions has not translated into significantly improved outcomes (Coast et al., 2012). Observations at health institutions in the Accra Metro area show that service delivery factors such as prenatal care coverage and the presence of a skilled attendant at delivery may play a significant role in the mortalities and therefore needs to be investigated to inform policy decisions if the Sustainable Development Goal (SDG) goal 5 is to be met. The causes of maternal deaths in Ghana follow the trends of the developing country with haemorrhage, hypertensive disorders, abortion related complications, and septicemia leading in that order (Mensah et al., 2011) . In this research study, I will examine the association between sociodemographic and service delivery factors and maternal mortality.

Purpose

The purpose of this study is to examine the socio-demographic and service delivery factors associated with maternal mortality in the Accra Metropolitan Area of Ghana. The maternal mortality rates are not the same in every region and therefore there is a need to investigate whether there are factors that are exclusive to some geographic areas.

Significance

Since Ghana did not achieve its Millennium Development Goal 5 (MDG 5) target, there has been renewed effort to achieve the Sustainable Development Goals on maternal death reduction, yet very little research has been done on the factors for which intervention would yield the most impact. As Accra Metro is a high urbanized setting characterized by rural urban migration, with so much pressure on relatively few health facilities (Report 2016), policy makers need more information on the major risk factors in this setting to guide decision making and resource allocation. The information gathered could inform the Metro and Regional Health Directorate on other policy interventions to help reduce maternal death in the Metro area. The positive social change implication that could result is to improve the quality of institutional antenatal, intra-partum, and post-partum service delivery in the Metropolis and add to the body of knowledge to reduce maternal death in Ghana.

Background

Selected papers and works relating to factors associated with maternal mortality and how to improve outcomes in West Africa particularly Ghana are described below:

1. Menendez et al. (2008) presented the causes and risk factors of maternal deaths as a major health problem in resource-poor regions of the world.

2. Addo and Gudu (2017) set out the various factors that are associated with the utilization of skilled service delivery among women that live in the rural part of northern Ghana.

3. Khan et al. (2006) demonstrated that reduction of maternal deaths is a key international development goal, therefore health policy and interventions targeted at significantly reducing it should be evidence-based.

4. Mahama (2013) reported that Ghana documented Maternal Mortality Ratio (MMR) of 350 per 100,000 live births for the year 2012.

5. The annual report at Accra Metropolitan area, Ghana (2016) documented 428 maternal deaths per 100,000 live births. This is a 39 percent increment on the 309 per 100,000 live births recorded in 2015.

6. Coast and McDaid (2012) reported that urban populations are mostly assumed to have improved access to health care as compared to their rural counterparts, however, urban health systems in many Low Income Countries and Lower Middle Income Countries have weak to non-existent public health structures and lack uniform implementation of strategies and necessary infrastructure.

7. Based on information from UNICEF and WHO, Blencowe (2012) indicated that the sub-Saharan African region had a Maternal Mortality Ratio of 500 deaths per 100,000 live births which is the highest in the world. This has made the region a dangerous place to give birth.

8. Osotimehin (2012) reported maternal death preventable interventions. These include improving access to voluntary family planning, investing in health workers with midwifery skills, and ensuring access to emergency obstetrics care when complications arise.

9. Mensah et al. (2011) described the causes of maternal deaths in Ghana. It followed the trends of causes in developing country, with haemorrhage, hypertensive disorders, abortion related complications, and septicemia leading in that order.

Framework

The theory of social capital is very broad and has found a place in public policy, public health, and more specifically in epidemiology. This theory is founded on several assertions. Chief among these assertions are that social relationships are a determinant of health (Begum, Aziz-un-Nisa, & Begum, 2003). The external environment and the daily social interactions and support systems play a pivotal role in an individual’s overall health. This theory is also founded on the premise that poor social capital is one of the leading causes of physical and mental distress (Krieger, 2011). To elaborate, a strong social connection has been shown to lead to improved all-cause mortality rates. Lack of social connection can have an adverse impact on health outcomes. Social epidemiologists are tasked with identifying the social aspects that affect the pattern of disease distribution and its mechanisms in a populace. Social relationships, social inequalities, and social capital are some of the most important concepts of social epidemiology. Krieger takes the position that social epidemiologists exploit indicators of ‘life chances’ such as occupation, skills and income which inform on social inequality. The underlying factors linked to social equality are the most important determinants of health. The knowledge, skills, and resources possessed by individuals are factors contributing to the social stratification and consequentially the health outcomes of a given population (Krieger, 2011). Research indicates a social gradient of health whereby most of the individuals with a lower socioeconomic position have been shown to have poor health (Krieger, 2011).

Social capital occurs at different levels. These include the macro-level (social, economic and political aspects of society), mesolevel (organizations and the neighborhood) and the individual context through social interactions. Many ecological studies conducted indicate a positive association between social capital and health outcomes (Mensah, Bentil, Adjepong, & Dolo, 2011). The concept of social inequality is of fundamental importance to epidemiology and health research since it is evident that social factors such as level of education and income levels impact access to health and the quality of health care services in a particular region. Epidemiologists can capitalize on this premise to establish health patterns in a given population informed by the socio-economic status of the persons residing there. Social support structures influence help-seeking behavior, adherence to medical treatment and use of health care services (Pearce, 1996). The theoretical aspects of social capital theory and factors behind them such as social inequalities, social capital, and social relationships will form an integral part of my research. This theory will serve as the framework to determine how and to what extent sociodemographic and service delivery factors can affect health care outcomes such as maternal mortality.

Research Questions

RQ1:

· Is there a significant association between sociodemographic factors (marital status, education, income, and health insurance) and maternal mortality in Greater Accra Ghana?

RQ2;

· Is there a significant association between service delivery factors (prenatal care, delivery location, and presence of a skilled attendant at delivery) and maternal mortality in Greater Accra Ghana?

RQ 3:

· Is there a significant difference in maternal survival rates between women in Greater Accra Ghana in terms of health insurance coverage, annual median income above GH¢30.00, education above the high school level, marital status, and location of infant birth?

Biology homework help

Name of Microorganism: ________________________________________________________ 1) Description of the Microorganism (week 1) a) Write a paragraph describing your organism. Please be sure to include the type of organism (bacterial, viral, fungal, protozoa, helminth, etc), morphology (shape, arrangement , colony morphology if applicable), description of structure (gram result, type of nucleic acid or virion structure, spore type, etc if applicable) and also the type of microscope and/or stain you would use to view the organism. Please use proper scientific terminology and good grammar and sentence structure throughout this project.

2) Virulence Factors a) Include a paragraph on the virulence factors the pathogen has and how they affect the host. Please enhance this with detailed explanations of the virulence factors and how they affect the host as you gain a better understanding of them throughout the semester.

3. Immunity a) Which defenses protect us from infection by this bacterium? b) Does this pathogen induce a specific type of immune response (example: delayed-type hypersensitivity)? If so, which one(s)?

4. Pathology (Infectious Disease Information)

a. What condition(s) or infectious disease(s) does it cause? b. Which tissues or organs are affected, and how are they affected (for example, chronic TB is characterized by lung tubercles)? Record your answers in the table below. c. Describe the complications that can result if the infection is left untreated. d. Are these acute, chronic, or latent infections? e. What organ system(s) does it infect? f. Is it an opportunistic pathogen? If so, where is it normally found in the body? 5. Epidemiology a. Draw and label a diagram on how this organism is transmitted. Make sure you include the reservoirs of infection, any vectors if involved in transmission, the type of transmission, and portals of entry and exit.

6. Presentations Provide a written, detailed description of a hypothetical patient. Be imaginative and create a hypothetical situation that would correspond with your microorganism. This is expected to be at least 8-10 sentences in length and is expected to be comprehensive and detailed. You are expected to include descriptions of:

a. Signs and symptoms, using correct terminology b. Patient history, including any situation that could explain how the infection was acquired (for example, if a food-borne intoxication is involved, when and how it could have been ingested?) c. Any condition that could have predisposed the patient to infection (diabetes; immunosuppressive therapy; burns, etc.). Note: Avoid the term “persons who are immune compromised,” for 2 reasons: It is a vague condition that has a variety of etiologies, and it is assumed that all persons who are “immune compromised” are at risk for all infectious diseases. d. Any data-specific indicators that would be important in a clinical setting, for example, urea or sugar levels in the blood or urine, elevated WBC, elevated CO2 levels, etc.):

7. Prevention a. Is there a childhood vaccine against this microbe? Name of vaccine b. If so, when is it administered (the recommended schedule, including boosters if recommended)? c. If the vaccine is not recommended during childhood, which at-risk group should get the vaccine, and when? d. Describe the type of vaccine and how it works : e. If there is no vaccine available, list at least three measures the can be implemented to prevent people from acquiring this infection. 8. Treatment a. Chemotherapeutic agents: b. Mechanism of action for these chemotherapeutic agents : c. Why is this agent efficacious against this particular organism ? b. Additional therapeutic agents or practices:

9 Clinical relevance: a. Are there any MDR (multi-drug resistant) strains of this microorganism? If so, name the strain(s) b. Is this strain a known healthcare-associated pathogen?

c. Which persons/procedures within a clinical or healthcare-assisted setting are particularly at risk?

b. Which antibiotics are used against the multi-drug resistant strains? Be specific.

10. References: Include at least 4 APA style references (scientifically appropriate credible resources) that show where you found the information in this microorganism profile.

Biology homework help

Name Ashley Waddy____________________

Biology 1111.06__________________

Chapter 7 Assignment

Worth 100 Points

Directions: Answer the following questions and/or statements below regarding understanding cellular respiration. Don’t forget to use the class format in answering these questions on the assignment. After you have completed the document, submit it in the appropriate dropbox. More than one submission will result in a 10-point penalty. Do not edit the document. The title along with the directions and questions must be included to avoid the 15-point penalty applied to the overall grade. Again, do not edit the document and add your answers to the original document. Remember, the submissions of pdf are not allowed in this class. If a pdf is submitted, you will receive a zero for the assignment for not following directions. Again, all work again should be placed in the dropbox. Also, the document that you submit should be a Microsoft Word Document. If your document is not a Microsoft Word Document, you will not receive any credit for the assignment. NO concessions will be given for late work, resubmissions, or concessions. Again, don’t forget that your answers should be written in the class template and to provide everything that is required for an assignment to avoid penalties. Check your syllabus regarding what is required for all activities

1. Write the chemical equation for cellular respiration. Circle the reactants and underline the products. C6H12O6 + 6O2 ———— 6CO2

2. Where in the cell does cellular respiration occur? It occurs in all the cells body and it is the reason we breathe.

3. Label the parts of the mitochondria – outer membrane, inner membrane, cristae (folds on the inner membrane). Type answer in the box.

4. Where do we get glucose from?

5. What gas combines with glucose in order for glucose to break down?

6. What type of organisms carry out cellular respiration?

7. What does cellular respiration produce for our cells?

8. Where is the energy in glucose stored?

9. What do humans & animals do with the CO2 produced when glucose breaks down?

10. What do plants do with the CO2 produced during cellular respiration?

11. What is the function of the mitochondria?

12. What do we do with the H2O produced when glucose breaks down?

13. What do plants do with the H2O they produce during cellular respiration?

14. What is energy? What is the energy current of the cell? What is energy used for in eukaryotic cells. Be specific. This answer must have at least 5 sentences in order to receive credit.

15. What does glycolysis mean?

16. Where in the cell does glycolysis occur? In the cytoplasm outside the mitochondria, is the breakdown of glucose to two molecules of pyruvate.

17. What is glucose broken down into during glycolysis?

18. Does glycolysis need/require O2?

19. Is glycolysis an anaerobic or aerobic process?

20. Where do the ATP’s that start glycolysis (stage 1) come from?

21. What’s the function of the Krebs Cycle and Electron Transport Chain (stage 2)?

22. What does fermentation mean? It is the anaerobic breakdown of glucose, resulting in the production of two ATP per glucose ensures that ATP is available for cellular processes.

23. Name the 2 types of fermentation. Acholic fermentation and lactic acid fermentation.

24. What organisms carry out alcohol fermentation?

25. Does alcohol fermentation require oxygen?

26. Why does bread dough rise? Explain this process with your understanding of fermentation. This answer must have at least 5 sentences to receive credit.

27. After we exercise strenuously our muscles are sore. Why? This answer must have at least 5 sentences to receive credit.

28. Does lactic acid fermentation require oxygen?

29. Does cellular respiration require oxygen?

30. How often does cellular respiration occur in our bodies?

31. Explain the preparatory reaction and its purpose in cellular respiration. This answer must have at least 5 sentences to receive credit.

32. How many ATP are produced in the Citric Acid Cycle? 6NAD+

33. What is the total amount of ATP produced in Glycolysis?

34. How many times does the Citric Acid Cycle turn to produce 6 NADH?

35. Explain the why ATP Synthase Complex is required in Cellular Respiration. This answer must have at least 5 sentences to receive credit.

36. What are the coenzymes that are used in cellular respiration?

37. Explain why fats produce more ATP than a glucose molecule. This answer must have at least 5 sentences to receive credit.

38. ATP Synthase Complex is found in which reaction that is a part of cellular respiration?

39. Why are H+ ions important for the output of cellular respiration? This answer must have at least 5 sentences to receive credit.

40. Tell one interesting thing that you learned about cellular respiration in chapter 7. This answer must have at least 5 sentences.

Inner membrane

Outer membrane

Cristae